Lawyer Resources for Medical Malpractice

medical malpractice casesMost people would gladly take care of their elderly parents and other loved ones, however, the supervision and intensive care that these elderly patients need is sometimes more than untrained individuals can provide. The need for adequate care leads to many families across the country finding a facility that will provide the dedicated care that our family members need. Oftentimes this is an assisted living facility or nursing home.

Medical malpractice or simple mistake?

However, despite their best intentions and education, when caring for the elderly, these nursing homes sometimes make a mistake. Remember that humans operate these facilities, and humans sometimes make mistakes. However, sometimes these errors may result in serious injury or even prove fatal for the nursing home resident. If that happens, the patient him- or herself (in the event of an injury or mistreatment) or the relatives of the patient may be able to take the facility to court for nursing home malpractice.

It is important to remember that these cases are always serious and often tragic. These elderly patients are always vulnerable, sometimes confused, and often frail. Because most people entering into a nursing home facility do so because they are no longer able to care for themselves, an injury or careless action could exacerbate matters even further.

The duty of the nursing home

Under the law, a nursing home has the duty to provide adequate care for its residents. This needs to be in line with the standards of similar facilities. If the nursing home or long-term care facility fails to provide this level of care, they are now legally “negligent.”

For the majority of medical malpractice cases it is possible to prove the standard of care by bringing in expert witnesses. These expert witnesses are usually physicians who will testify what is deemed appropriate care and explain how a doctor violated that particular standard.

Fortunately, because government regulation determines the standards for nursing home care, it is far clearer to prove medical malpractice. Moreover, because the public has access to records of incidents that occur in nursing home facilities, it can make the investigation into medical malpractice for a nursing home a lot easier.

Types of nursing home malpractice

There are several different types of nursing home malpractice. The three most common include the following:

  • Inadequate care – Oftentimes nursing homes are understaffed or not properly staffed. As a result, patients do not receive the necessary care and may end up injured. This is certainly negligent and may constitute medical malpractice if the patient ends up becoming injured. Bedsores may occur if the nursing home staff fails to properly monitor the patient and occasionally turn them. Inadequate hygiene may lead to different types of infections. These examples qualify for medical malpractice.
  • Abuse – It does not matter if this is verbal, physical, emotional, or sexual abuse, any type of abuse incident should always be explored to the fullest. Oftentimes these incidents happen because of inadequate screening and supervision of staff.
  • Medical mistakes – Because many of the nursing homes are trying to save money and cut corners where they can, it is possible that staff members feel overworked when distributing medication. This may result in patients not receiving the dosage they need or receiving too much at once.

Remember that there is always a statute of limitations with medical malpractice claims. If you notice something that concerns you, it is important to speak out and make your voice heard. It is important to be aware of specific areas for concern, dehydration, losing weight, acting nervous around certain staff members, broken bones, bruises or sores, these may all be signs of negligence or abuse.

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Hospital Stays Longer Because of Nursing HomesWhile many low income individuals who have Medi-Cal (California Medical Assistance Program) are thrilled to have state-provided medical insurance, it may not be enough to provide them the coverage they require to stay in nursing homes long-term. Recently, the California Advocates for Nursing Home Reform, a watchdog group, alleged that administrators of nursing facilities throughout California have been sending patients covered by Medi-Cal to hospitals to free up beds to make room for patients with insurance that can pay the nursing home more. Because of that, many low income patients only have the option of staying in hospitals indefinitely because no nursing facility will readmit them back in.

By federal law, states are required to provide patients a readmission hearing after an initial hospital stay is over and they have been formally discharged. However, California has been slow to enforce this requirement, creating a loophole for nursing home administrators to generate greater profits. The lawsuit filed by the advocate group claims that this refusal of a readmission hearing mandates that welfare patients must remain in the hospital to receive much-needed care. This lack of enforcement directly violates the 1987 Nursing Home Reform Act when Congress passed sweeping reforms to ensure that residents of every nursing facility would receive optimal medical care and hygiene assistance.

To remain financially lucrative, many nursing facilities receiving Medicare funds will turn away low income potential residents in favor of lucrative clients with better insurance. The practice of “patient dumping” often goes unchecked, especially when the patient is suffering a severe mental or medical health condition.

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Costs of Reduced Hospitalizations for Nursing Home PatientsHospitalizations for nursing home patients are a costly expenditure for Medicare, running about $4 billion a year nationwide. It is not a surprise that finding ways to reduce the amount of trips to the hospital is a hot topic when looking at ways to cut spending. Researchers at the Florida Atlantic University (FAU) have jumped on the bandwagon and believe they have found a solution to reducing unneeded hospitalization for nursing home patients and a way to save the country millions of dollars. The only question is what the cost will be to the patients.

Researching the Problem.

FAU recently received a $1.8 million grant to continue their research into the reduction of hospital stays for nursing home patients. They have devised a program to train nursing home staff to look for early signs of medical issues and evaluate whether the patient needs further medical attention. The program is called Implementing Interventions to Reduce Hospitalizations of Nursing Home Residents, or INTERACT.

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hospital For many elderly people, a short trip to the hospital can bring about justifiably intense fears. A recent study in the medical journal Neurology found that more than half of elderly patients experience dramatic cognitive decline after short hospital stays. The study took a look at 1,870 people up to 12 years after their treatments.

“Essentially, it’s as if people become 10 years older…than they actually were before a hospitalization,” said Dr. Robert Wilson, a lead author of the study. “We think that a hospital can…accelerate previously unidentified cognitive problems.”

Elderly patients are also more susceptible to pneumonia, medication errors, bed sores and infections during hospital stays. According to a recent article from Harvard Medical School, those who stay in bed for long periods of time rapidly lose muscle strength. Multiple sources say as many as two-thirds of patients age 70 and up emerge from hospital stays in worse shape than they arrived.

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image04-300x201[Photo Caption: Up to 15,000 elderly people may be losing their lives each month due to preventable hospital errors.]

A recent article in the noted medical policy journal Health Affairs claims that the number of people who die as a result of hospital-acquired conditions is still unclear. While some government agencies say 90,000 people die a year, the number may very well be vastly higher.

“The extent of patient harm in primary care….remains almost a mystery,” said the article. “If patients’ lives count, it’s long past time to count, and counter, every type of preventable harm.”

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woman in hospital bedThe overwhelming number of hospital-acquired pressure sore cares derive from a medical system that is focused on treating a patients acute care needs as opposed to maintaining the patient’s overall well-being. 

While the origins of hospital-acquired pressure sore (bed sores) cases and pressure sores that originate during a nursing home admission are quite similar with respect to the underlying factors behind their development, the cases can vary substantially when it comes to a litigation perspective. 

Despite the relatively elementary reasons for their development, hospital bed sore cases can become quite complex when the necessary legal maneuvering associated with medical malpractice cases gets involved.

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Medication Must Be Properly MonitoredI highly suggest taking a look at the New York Time’s recent “Well” column, Four Drugs Cause Most Hospitalizations in Older Adults, as a real wake up call for medical facilities— such as nursing homes— to do a better job monitoring the effectiveness in their patients.

The article has some interesting / concerning information concerning commonly prescribed medications that account for a staggering number of hospitalizations in the elderly every year.  An amazing 66% of emergency hospitalizations in the elderly are related to adverse reactions such as accidental overdoses of:

  • Warfarin / Coumadin- a blood thinner
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medical-chartWhen it comes to the effective prosecution of nursing home negligence cases or medical malplractice cases, medical records are a crucial piece of the puzzle in determining the essentials: who, what, where– and sometimes why. 

Pursuant to the following federal regulations, nursing homes must create, maintain and release medical information to patients or their authorized representatives:

  • F-514 §483.75(l)(1)&(5) – Maintaining/Content of Clinical Records
  • F-515 §483.75(l)(2) – Retention of Clinical Records
  • F-516 §483.20(f)(5); §483.75(l)(3) – Release of Resident Identifiable Information / Safeguarding Clinical Record Information

Obtaining copies of medical records from nursing nursing homes can become quite complicated in situations where a patient becomes disabled or dies.  A maze of privacy laws and probate laws, can rapidly make a (seemingly) straightforward process difficult. 

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elderly in hospital.jpgPerhaps nursing home patients are more frail and vulnerable than we already thought? A recent study published in the Annals of Surgery essentially concluded that nursing home patients are significantly more vulnerable to complications following a surgery than their peers living in the community.  

The study looked at sample groups of both nursing home patients and elderly people living in the community and the differences between the two groups are striking.  For example when researchers looked at surgical procedures, they discovered:

  • Nursing home patients were six times more likely to die within a month following the removal of their appendix
  • Surgery for bleeding ulcers claimed the lives of 42% of nursing home patients, while the same procedure only claimed 26% of the lives of patients living in the community
  • Colon surgery death rates were more than 50% higher for nursing home patients compared with their peers, claiming 32% of nursing home patient lives vs. 13% of their community peers.

In addition to significantly higher mortality rates, researchers similarly found that nursing home patients had more post-operative complications and required more rehabilitative treatment than similarly situated people living outside of skilled nursing facilities.  According to Dr. Emily Finlayson, the studies lead researcher, “[p]atients who survived had to undergo invasive procedures after surgery which means more time on the ventilators, more people getting feeding tubes and more time in the ICU.”

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potassium.jpgPoor communication appears to be to blame for the death of a woman at a Minnesota nursing home who was administered a dose of medication ten times higher than prescribed by her doctor.

According to news reports concerning this incident, a transcription error is likely to blame for the patient receiving 80-milliequivalent doses of potassium over an eight day period while she was a patient at Bethany Home of Alexandria.  A state investigation determined that the improper potassium dose was to blame for her cardiac arrest.

Making this tragedy even more concerning is the fact that the exceedingly high dose was recognized by a pharmacist who was filling the woman’s prescription who brought the unusually high dose to the attention of staff at the facility— only to be discounted.

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